1. Promoting Safety and Health in the Workplace - CONTACT CENTER - Occupational Safety and Health Center Department of Labor and Employment

2. Occupational Safety and Health encompasses the social, mental and physical well-being of workers, that is the whole person

3. Lesson 1. Learn from the past and prepare for a better future

4. The World of Work then … "a foul and poisonous dust [that] flies out from these materials, enters the mouth, then the throat and lungs, makes the workmen cough incessantly, and by degrees brings on asthmatic troubles." "in whom he found heaps of sand that in running the knife through the pulmonary vesicles he thought he was cutting through some sandy body."

5. Bernardini Ramazzini Father of Occupational Medicine 1713 – Published De Morbis Artificum (Diseases of Workers)

6. Paracelsus (1493-1541) Father of Modern Toxicology Areolus Phillipus Theophrastus Bombastus von Hohenheim "All substances are poisons; there is none which is not a poison. The right DOSE differentiates a poison from a remedy."

7. Lesson 2. Know the conditions of work and workplace

8. Occupational and Work-Related Diseases and Injuries History of exposure to hazardous workplace factors becomes indispensable in determining whether an illness is because of workplace factors or not.

9. Types of Hazards Biologic hazards Chemical hazards Physical hazards Ergonomic stresses

10. Types of Hazards Chemical hazards Formaldehyde Cigarette smoke Carbon monoxide Carbon dioxide Cleaning Agents

11. Types of Hazards Physical hazards Poor office lighting Noise Dry air Air currents

12. Types of Hazards Biologic hazards Pollens, allergens and dusts People, plants, mites, pests Condensed water in air conditioners, clogged drains, etc.

13. Types of Hazards Ergonomic stresses Limited workspace Simplified work Repetitive task Shiftwork (esp. nightwork) Mental and physical workload

14. Lesson 3. Mere exposure to hazard does not cause harm to safety or health

15. Hazards in the workplace can cause harm if there is undue exposure such as through elevated workplace concentration without proper control measures. Important to characterize exposure

16. Work-Related Musculoskeletal Disorders (WMSDs) development requires weeks, months or years of exposure to ergonomic risk factors Repetitive exertions Posture stresses (including static posture) Forceful exertions Contact stresses Job design Work organization Workstation dimension

17. Lesson 4. Take active part in keeping yourself safe and healthy.

18. Diseases of Workers Many diseases of occupational cause are multifactorial,with non-occupational factors playing a role. Personal characteristics, other environmental and socio-cultural factors usually play a role as risk factors for these diseases.

19. Total Health Promotion Smoking cessation Physical activity Nutrition Weight reduction HIV/AIDS Drug Abuse Prevention TB Prevention and Control

20. Lesson 5. Prevention is better than treatment

21. HARMFUL EXPOSURES EARLY IN WORKING LIFE MODIFY NORMAL COURSE OF PHYSIOLOGICAL CHANGES DUE TO AGEING ALONE

22. Hearing loss comes with ageing But hearing loss can occur much earlier due to occupational exposure

23. Noise-Induced Hearing Loss

24. Loss of muscle strength comes with ageing But muscle strength can be diminished even in young persons

25. Occupational Safety and Health is Prevention Many occupational conditions are IRREVERSIBLE Occupational conditions are PREVENTABLE

26. ENSURING WORKER WELL-BEING The choice of a starting age for attention should be selected as young enough that intervention efforts can be expected to make a difference during the working life. Committee on the Health and Safety Needs of Older Workers National Research Council and Institute of Medicine

27. Occupational Safety and Health Conditions Contact Centers

28. Occupational Safety and Health in Call Centers (Secondary Data) Musculoskeletal disorders –Linked to poorly designed workstations (Hoekstra et. al. 1995). –Associated with longer shift duration (Ferreira M and Saldiva PH, 2002) –Long uninterrupted hours of work with the computer –Invariable and sedentary work (Norman K et. al. 2001) –Low job satisfaction (Most IG, 1999)

29. Occupational Safety and Health in Call Centers (Secondary Data) Voice disorders –Intensive verbal interaction with clients one of the contributing factors (Jones K et. al., 2002) Eyestrain –Poor lighting conditions and intensive computer use (Putnam C et. al., 2000)

30. Occupational Safety and Health in Call Centers (Secondary Data) Problems due to psychosocial and work organization stressors (Putnam C et. al., 2000) –Increased reporting of health disorders –Negative work attitude (boredom, job dissatisfaction, anger, etc.)

31. Occupational Safety and Health in Call Centers (Secondary Data) Concern over potential hearing problems (Patel J and Broughton K, 2002) –Exposure to high intensity sound coming from the headsets –high sound levels in the room from the simultaneous talking of the employees

32. Occupational Safety and Health Conditions Contact Centers in the Philippines

33. Methods Case study of 5 call centers Purposively selected employees from one (1) company –Questionnaire to collect data about personal circumstances, occupational profile, medical and psychosocial conditions –Company profile Data will be collected regarding the organization in terms of size, tasks, type of clients, work organization, working hours, etc. Information on incentive system will also be gathered.

34. Results 5 call centers Varying tasks of operators –1 call center with only interactive computer task (internet online communication) –4 call centers both voice and computer

35. Results ABCDE Year Established 1998200220001999 TaskIntensive interactive computer work (chatting) Voice and computer Nature of business Customer assistance Telemarketing, outbound Telemarketing (outbound) and customer care services (inbound) Telemarketing, mostly outbound Telemarketing, inbound GenderEqual proportion of male and female 70% female80% female75% female Age of operators 20 - 2520 -20 - 3520 - 25

36. Results Hazards Identified ABCDE Working Posture Rapid and repetitive keying, prolonged sitting, static exertions of neck, torso, elbow freedom of movement (sit, stand, walk about) Prolonged sitting, twisting of upper body and neck to view monitor

37. Results PARAMETERSFrequency of Extreme Posture Observed Eye position39 agents with upward gaze Upper arm positionRaised upper arms and elevated shoulders in 43 agents Lower arm positionElbow flexed in 28 agents Wrist/Hand positionWrist flexed in 4 agents Wrist extended in 38 agents Neck positionExtremely flexed in 5 agents Erect position in 50 agents Trunk position38 agents leaning forward Working Posture of Call Center Agents Company E (n=55)

38. Eye symptomsWith symptom/s in the last 7 days With symptom/s in the last 6 months Smarting22 (29%)35 (47%) Gritty4 (5%)8 (11%) Itchiness13 (17%)24 (32%) Eye pain15 (20%)25 (33%) Redness16 (21%)29 (39%) Tearing10 (13%)21 (28%) Dryness9 (12%)15 (20%) Sensitivity to light15 (20%)31 (41%) Frequency of eye symptoms among call center agents (n=73)

39. Frequency of musculoskeletal symptoms among call center agents (n=72) Musculoskeletal symptoms With symptom/s in the last 7 days With symptom/s in the last 6 months Neck4 (6%)36 (50%) Shoulder2 (2%)22 (30%) Elbow-2 (2%) Wrist-10 (14%) Upper back4 (5%)41 (57%) Low back3 (4%)33 (46%) Hips or thigh1 (1%)11 (15%) Knee-5 (7%) Ankle or feet-7 (10%)

40. Frequency of hearing and voice disorders among call center agents (n=73) Hearing and Voice disordersWith symptom/s in the last 7 days With symptom/s in the last 6 months Ear pain-12 (16%) Ringing in the ear-9 (12%) Need to raise voice when talking 1 (1%)15 (20%) Hoarseness1 (1%)35 (48%) Tiredness or weakness of voice3 (4%)53 (73%) Exerting more effort to talk2 (2%)37 (51%) Cracking of voice3 (4%)30 (40%) Choking sensation2 (2%)20 (27%) Burning sensation in throat-17 (23%) Dry throat1 (1%)52 (71%) Complete loss of voice1 (1%)4 (5%)

41. Lesson 6. Proactive measures are better than reactive efforts

42. Work Elements and associated Risk factors of voice disorders Work EnvironmentJob Design/ Organization Individual/ Psychosocial Factors a.High intensity of background noise b.Poor room acoustic c.Low temperature and humidity d.Poor workplace air causing irritation a.Prolonged heavy use of voice b.Fast paced work brought about by automated call routing or dialing system c.Repetitive reading from long scripts d.Lack of or inadequate breaks a.Habit of speaking loudly b.Smoking c.Frequent intake of caffeinated beverages d.Infrequent hydration e.Infections involving the throat f.Intake of throat drying medications

43. Work Elements and associated Risk factors of hearing disorders Work EnvironmentJob Design/ Organization Individual/ Psychosocial Factors a.High intensity background noise b.Noise from headsets c.Poor room acoustic a.Long duration of work b.Infrequent breaks c.Inadequate number of headsets a.Poor hygiene b.Lack of training on proper maintenance of headsets

44. Work Elements and associated Risk factors of visual fatigue Visual Display Work EnvironmentWork Position Job Design/ Organization Individual/ Psychosocial Factors poor image quality, flicker, character size (too small or too big) a. poor illumination, excessive contrast in visual field, glare, reflections b. high vertical position of the display which may lead to dryness c. inappropriate viewing distance between worker and screen, keyboard, document d. dry air (relative humidity <40%) e. air movement >0.5 m/sec upward gaze direction a. long duration of work, esp. if without breaks b. high degree of concentration required c. fast pace of work d. repetitive and invariable task a. uncorrected visual deficiencies b. inadequate training on VDT operation

45. Work Elements and associated Risk factors of work- related musculoskeletal disorder Physical Work Environment Workstation Design Work PostureJob Design/ Organization Individual/ Psychosocial Factors Contributing to improper posture a. inadequate lighting b. presence of glare and reflections on the screen a. chair without proper lumbar support b. not height adjustable chair and keyboard c. too high or too low position of monitor or keyboard d. inadequate workspace a. static posture b. repetitive keying or mouse manipulation c. non-neutral posture (head or body twisted to one side; wrist flexed or extended; elevated shoulders) a. long duration of work, esp. if without breaks b. high degree of concentration required c. fast pace of work d. invariable, repetitive task e. high performance quotas a. uncorrected visual deficiencies b. inadequate training on computer operation c. lack of job control d. low job satisfaction

46. Health, Safety and Social Issues Risk Factors Associated with Night Work Sleep disorders Continued poor quality sleep Gastrointestinal disorders a.Digestive function reduced at night. b.Intake of coffee and other drinks containing caffeine c.Increased incidence of smoking to keep awake at night d.No access to proper meals at night because canteens are closed at night e.irregular meal times and snack Errors and Accidentsa.Decreased alertness corresponding to trough of circadian rhythm b.Sleep debt c.Cumulative fatigue Substance abusea.Alcohol used to overcome fatigue and sleep debt b.Amphetamines and caffeine used to keep awake at night Physical attack Walking very late at night or very early in the morning because public transport may not be available at these times Disruption in the pattern of social practices a.Exclusion from events and activities involving the family, friends or community b.Lack of contact with partners, children and friends c.Inability to pursue education, sports etc.

47. Implications of the Study Knowledge gained to be used to improve working conditions –In existing and prospective new call centers –Address the OSH problems at an early stage Policy/Program Implications –needs of women, mothers, young workers –policies concerning work shifts, esp. prolonged night work –adequate, on-site medical and health promotion facilities

48. Implications of the Study Recognition of complex nature of safety and health issues in call centers –Interaction of psychosocial factors with other work factors –Unique work organization because of electronic monitoring –High performance standards –Issues on job security Compensation implications –Recognition of problems of workers in call centers Associated with air quality, ambient noise, noise from headset, human-computer interaction, shift work, etc.

49. Approach in Ensuring Well-Being of Workers Looking at regulatory requirements Relevant laws, standards, issuances and guidelines –Enforcement –Implementation –Inspection –Evaluation Looking at developmental strategies Information Education Training Campaigns Good practices Successful cases Competitions Demonstrations Interventions

50. Participatory approach Participation and involvement from stakeholders Coordinated intervention Learning from –specifications/guidelines, –scientific data –best practice

51. Prevention of disease/injury Promotion of good health and safety Improvement of safety and health HEALTHY, SAFE, COMFORTABLE PRODUCTIVITY The Link

52. Lesson 7. Prepare yourself